Article

Clinicopathologic characteristics of invasive lobular carcinoma of the breast: results of an analysis of 530 cases from a single institution.

Section of Anatomic Pathology, Department of Oncological and Surgical Sciences, University of Padova, Padova, Italy.
Cancer (Impact Factor: 4.9). 08/2008; 113(7):1511-20. DOI: 10.1002/cncr.23811
Source: PubMed

ABSTRACT Although invasive lobular carcinoma (ILC) is the second most common histotype of breast cancer, the prognostic implications of its clinicopathologic characteristics remain controversial.
The authors undertook a retrospective analysis of a large series of cases treated and followed at a single institution, with the objective of assessing the prognostic/predictive value of distinct clinicopathologic features of the tumors, after revision of the original histopathologic preparations and statistical analyses.
Overall, 530 patients with pure ILC (57% with the classic type; 19% with the alveolar type; 11% with the solid type; and the remaining 13% characterized by pleomorphic, signet ring cell, histiocytoid, or apocrine features) were included in the study. Tumor size, lymph node metastatic involvement, and hormonal status were confirmed to be significant prognostic factors. In addition, statistically significant correlations were demonstrated between the 'classic' histotype of ILC and a lower risk of axillary lymph node metastases (P = .0005), a reduced number of metastatic lymph nodes (P = .04), and lower tumor grade (P < .0001). Patients with ILC of the 'nonclassic' subtype demonstrated significantly increased breast-related events (hazards ratio of 1.80; 95% confidence interval, 1.04-3.10) and a trend toward reduced disease-free survival and overall survival.
The results of the current study confirm the clinical usefulness of several traditional clinicopathologic features of ILC as prognostic parameters but also emphasize the prognostic role of the histopathologic subtyping of these tumors, documenting the more favorable outcome of the classic subtype of ILC.

1 Bookmark
 · 
97 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of the present study was to investigate the long-term impact of prognostic factors in invasive lobular carcinoma (ILC) of the breast, with a primary focus on Ki67 and histological grade, alone and in combination with estrogen receptor (ER). One hundred and ninety two well-characterised patients with ILC were included in the study. Ki67, histological grade and ER were evaluated and combined into a prognostic index (KiGE). All grade 1 tumours and ER-positive (ER+) grade 2 tumours with Ki67 ≤ 30% were classified as low-KiGE and all the others as high-KiGE. Overall, 31% of the patients have died from breast cancer. The median follow-up of the patients still alive was 21 years. Age, tumour size, axillary lymph node status (nodal status), histological grade, Ki67 and KiGE were significant prognostic factors for breast cancer mortality (BCM) in univariable analysis. In a multivariable model, adjusted for adjuvant treatment, age and progesterone receptor (PgR), the strongest prognostic factors for BCM were: Nodal status (hazard ratio (HR) = 2.9, 95% confidence interval (95% CI): 1.4-6.1), KiGE (HR = 2.0, 95% CI: 1.1-3.6), and tumour size (HR = 1.9, 95% CI: 0.98-3.8). By combining these three factors, 37% of the ILC's could be further divided into a low-risk group, consisting of node negative small (≤ 20 mm) low-KiGE tumours, with a BCM of 5% (95% CI: 1-13%) at 10 years and 12% (95% CI: 5-22%) at 20 years follow-up. None of these patients recieved chemotherapy and only 2 recieved endocrine treatment with tamoxifen. The combination of Ki67, histological grade and ER into KiGE, together with tumour size and nodal status make it possible to identify a large group of ILC patients with such a good long-term prognosis that chemotherapy can be safely avoided and exclusion of endocrine therapy considered.
    SpringerPlus 01/2014; 3:70.
  • [Show abstract] [Hide abstract]
    ABSTRACT: About 3-5% of metastatic cancers originate from an unknown primary origin. Some have a signet-ring cell (SRC) component. We report the medical history of three patients with SRC carcinoma expressing both the oestrogen (ER) and progesterone receptors (PR). Although no primary breast cancer could be identified, we considered these three patients as having metastatic breast cancer. All of them were therefore treated with standard breast anti-hormonal therapies and all demonstrated benefit. The pitfalls of clinical presentation, diagnostic work-up, and treatment are discussed.
    Acta clinica Belgica. 04/2014; 69(2):135-8.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Die WHO-Klassifikation der Tumoren der Mamma bildet international die Basis für die Einordnung und Nomenklatur der Tumoren. Die 2012 erschienene 4. Auflage spiegelt unser gegenwärtiges Verständnis zur Klassifikation, Immunhistologie, Differenzialdiagnose und Genetik der Läsionen wider. Verglichen mit der 3. Auflage enthält sie einige Änderungen in der Terminologie. Etablierte Entitäten wurden neu bewertet und zahlreiche molekulare Aspekte wurden hinzugefügt. Dieser Beitrag behandelt die invasiven Karzinome. Die histopathologischen Definitionen der aktuellen WHO-Klassifikation werden durch die Beschreibungen der klinischen, makroskopischen, molekularen sowie prognostischen und prädiktiven Eigenschaften der Tumoren ergänzt.
    Der Pathologe 02/2014; 35(1). · 0.64 Impact Factor

Full-text (2 Sources)

Download
9 Downloads
Available from
Oct 5, 2014